Last fall I attended the Cleveland Clinic’s 10th Annual Obesity Summit, a conference I like to go to whenever I can. During the event, I live tweeted snippets from various expert speakers. Given the complex nature of overweight/obesity,* I thought it might be interesting to expound on some of them.

Preventable Chronic Disease

50% of U.S. adults have one or more preventable chronic diseases related to poor quality diets & physical inactivity. Kirby, MD #obesity15

Notice the above tweet does not say “50% of obese U.S. adults.” Regardless of our number on the scale,half of us could better our health by improving our diet and physical activity, no medication required. For example:

We could lower our risk of type 2 diabetes by eating less sugar and more whole grains and vegetables.

We could increase our bone density by doing weight-bearing exercise and eating foods rich in calcium and vitamin D.

We could lessen cell damage that leads to cancer, heart disease, and Alzheimer’s by eating foods rich in antioxidants like berries, beans, and apples.

Best Diet Out There?

Mediterranean Diet might be best diet because it has good outcome data on heart disease & it's easier to adhere to. Bessesen, MD#obesity15

The speaker’s point was not to say the Mediterranean Diet is the best diet for weight loss and weight maintenance. Rather his point was that no matter how effective a diet is, if we can’t adhere to it—for example, a diet that’s too restrictive—we won’t maintain weight loss. Butsince the Mediterranean Diet is tasty and easy to stick with, it’s a good “best diet” candidate. Plus, studies support its heart-healthy benefits.

Hormonal-Induced Resistance to Weight Loss

That complicates the equation of calories in minus calories out, doesn’t it? Our bodies do not like change. They want to maintain homeostasis. Sowhen we lose weight, our bodies go into preservation mode and try to gain it back, making continued progress that much more difficult.

Furthermore, when we reach a certain BMI through dieting, we may not be able to eat as many calories as someone who’s always been at that BMI.

Obesity and Infection

Infectious contributor to obesity? Those exposed to adenovirus (Ad36) had higher BMI than those unexposed. (Dhurandhar, PhD) #Obesity15

Research animals infected with adenovirus-36 (Ad36) had a 60-100% increase in body fat, even though they ate the same amount as animals not given the virus. In another study, 30% of obese people had antibodies to Ad36 virus compared to 11% of normal-weight people.

This shows just how complex the issue can be, which leads nicely to the final tweet:

Obesity Is a Multifactorial Disorder

We need to resist the simplistic assumption that the individual alone is responsible for overweight/obesity or that weight loss is as simple as eating less and exercising more. In the past 30 years, the obesity rate has more than doubled in adults and children. It has quadrupled in adolescents.

People didn’t suddenly lose their willpower since the 1980s. Certainly we’re more sedentary than we used to be, a product of both our built environment and our increased reliance on technology. We’re also bombarded with addictive food high in fat, sugar and salt, and we cook less of our meals at home. Plus, our portion sizes have ballooned, along with the number of advertisements that entice us.

But research suggests there is even more at play, including genetic, hormonal, infectious, social, and even chemical factors (e.g., BPA).

One thing is clear, however: a multifactorial problem requires multilevel interventions. Only when we target all the forces behind obesity will we see any lasting change. Yes, the responsibility ultimately falls on the individual, but to ignore these other forces is to invite failure.

After all, how has it been working for us so far?

Word cloud created by me at WordItOut.com.

*Note: I use the term “obesity” in my writings because it is the medical word for the condition and its meaning tends to be universally understood. It is not, however, my favorite word—I find it clinical and rather cold. My apologies to those who feel the same.

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Carrie Rubin is a medical thriller author with a background in medicine and public health. For full bio and a list of her books, click here.

I was following your tweets explanations, they are quite informative Carrie, I’m so grateful that l have learnt some “do’s” to maintain a healthy living. Many a Times I am told of the “don’ts” when it comes to issues of overweight / obesity. Thanks for expounding.

With you on controlling sugar intake. I think of myself as pretty good, but then think back over each day — oh yeah, honey on the cereal, banana, bread (which turns into sugar)r, raisins, those ‘healthy’ high-density turmeric/date squares that are nice and sweet, salad dressing with balsamic vinaigrette. On it goes. With you on healthy fats, too. Thank you again for broadening the discussion about the complexities behind the obesity epidemic. Cheers —

Interesting to expand upon your tweets like this! I think I’ve mentioned before but I tend to not be too worried about avoiding fat, but I try and avoid too much sugar, mostly because I notice an instant bad effect from it, well by “instant” I mean within a few hours.

Most of the fat I cook with is the good kind (olive oils and such), although I’d be lying if I said I never use butter. Sometimes you just need that butter fat to form a good sauce. But I definitely limit those dishes to only occasionally. Because sometimes you just have to have some homemade mac and cheese.

Very helpful and meaningful messages you are passing out using research and your years of studying, Carrie! I have tried living with freshest fruits, veggies and whole grains, some fish and still eat meat for protein. Best to get natural foods with only a few ingredients. This is all included in the Mediterranean diet, except maybe meat? I like learning your point of view on foods and habits, since you are my closest expert I know! 🙂

Love this article — and all of your tweets to help make your point. Very clever!

Carbs are my downfall. A while back (about 8 years ago) I was getting sick — a lot — and a friend of mine who is a psychiatric NP ordered me to get some blood work done. She read the results and discovered I was borderline diabetic from “carbohydrate abuse.”

Back then, the kids were running me ragged with their schedules and I was spending a lot of time helping my mom, this all on top of working and running the household — no time to cook a meal for myself, so I was eating anything fast and easy (which, of course, are carb-laden foods).

She put me on a strict low-carb diet, and I haven’t been sick since!

The interesting point she made to me about this is that no one would have even guessed I could have been diabetic because I wasn’t obese or overweight. I didn’t present with the classical signs of diabetes. She just picked up on the fact that I was constantly sick — with colds, laryngitis, flus galore — and put two and two together. My regular physician never figured this out — he just kept prescribing me meds.

I have slowly re-introduced carbs into my diet because I was having major cravings (I’m a sucker for pizza and homemade desserts). But now, I’m careful to balance the carbs with plenty of protein. Going on several years now since her diagnosis, and my sugar levels remain steady. Sometimes, I’ll slip and eat something too sugary at the wrong time of day and I’ll feel it (shaky and lightheaded), and then I know I was a bad girl!

It’s really important to pay attention to how our bodies behave and respond to food and activity. I’m much more aware of my eating habits now, and I feel much better for it!

We really are what we eat, aren’t we? I don’t think people really realize that until they start eating healthier and see how much better they feel. I know if I have a day of low nutrition, I feel draggy and queasy.

Thanks for sharing your experience. Goes to show it’s not all about the number on the scale.

Carrie, you know how I feel about this. I have no medical degree to back my experience, just a whole lot of experience – history of diet after diet that did not work, fitness regimes which did nothing but exhaust me totally in mind and body, insults and put-downs without end from those tolerant folk with simplistic answers to life. I got my body shape from twelve hour days and six-seven day weeks of hard physical work which I fuelled with sugar for the quick burn. I invented the ten-minute lunch. Once I stopped that work – or rather was stopped by illness, and once I stopped smoking, because I lived on my nerves, the weight gain began. I affirm as I repeatedly do that sugar is an addiction – much more so than nicotine and perhaps as much as any of the hard drugs you care to think of. But there, I guess until we learn to treat the mind and not the body, we will remain unenlightened.

Well said, and you know I’m in agreement. Sugar addiction is real, and though we’re starting to see this now, we’re nowhere where we need to be in dealing with it. Since food–unlike nicotine or alcohol–is a necessity to life, the waters are murky with how best to address the issue. The food industry–not to mention our taste buds–are deep into the world of unhealthy. It will take some time to turn things around. Let’s hope we can get them too.